Comprehensive imaging manifestations of tuberous sclerosis.

OBJECTIVE: The purposes of this article are to describe the abdominal manifestations of tuberous sclerosis, including renal and hepatic angiomyolipomas, splenic hamartomas, and renal cysts; the differentiation of renal angiomyolipomas from renal cell carcinoma by use of various imaging modalities; and the key imaging findings of intracranial subependymal nodules, giant cell astrocytomas, cortical tubers, lymphangioleiomyomatosis, cardiac rhabdomyomas, and osseous lesions. CONCLUSION: Tuberous sclerosis is an autosomal dominant neurocutaneous syndrome characterized by various abnormalities, including multisystemic hamartomas. Correct diagnosis of this syndrome is imperative, not only by detecting cutaneous manifestations at physical examination but also by recognizing the characteristic multimodality imaging findings. Patients can present with a variety of symptoms, ranging from seizures to acute abdomen with life-threatening hemorrhage. The mortality rate is as high as 40% by the age of 35 years.

Defining MRI Superiority over CT for Colorectal and Neuroendocrine Liver Metastases.

BACKGROUND: We compared CT and MRI for staging metastatic colorectal or neuroendocrine liver metastases (CRLMs and NELMs, respectively) to assess their impact on tumor burden. METHODS: A prospectively maintained database was queried for patients who underwent both imaging modalities within 3 months, with two blinded radiologists (R1 and R2) independently assessing the images for liver lesions. To minimize recall bias, studies were grouped by modality, and were randomized and evaluated separately. RESULTS: Our query yielded 76 patients (42 CRLMs; 34 NELMs) with low interrater variability (intraclass correlation coefficients: CT = 0.941, MRI = 0.975). For CRLMs, there were no significant differences in lesion number or size between CT and MRI. However, in NELMs, Eovist®-enhanced MRI detected more lesions (R1: 14.3 vs. 12.1, p = 0.02; R2: 14.4 vs. 12.4, p = 0.01) and smaller lesions (R1: 5.7 vs. 4.4, p = 0.03; R2: 4.8 vs. 2.9, p = 0.02) than CT. CONCLUSIONS: CT and MRI are equivalent for CRLMs, but for NELMs, MRI outperforms CT in detecting more and smaller lesions, potentially influencing treatment planning and surgery.